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. 2021 Jun 8;11(6):1053.
doi: 10.3390/diagnostics11061053.

Diagnostic Value of Whole-Body MRI Short Protocols in Bone Lesion Detection in Multiple Myeloma Patients

Davide Ippolito  1   2 , Teresa Giandola  1   2 , Cesare Maino  1   2 , Davide Gandola  1   2 , Maria Ragusi  1   2 , Paolo Brambilla  3 , Pietro Andrea Bonaffini  2   3 , Sandro Sironi  2   3
Affiliations

Diagnostic Value of Whole-Body MRI Short Protocols in Bone Lesion Detection in Multiple Myeloma Patients

Davide Ippolito et al. Diagnostics (Basel). .

Abstract

The aim of the study is to evaluate the effectiveness of short whole-body magnetic resonance imaging (WBMRI) protocols for the overall assessment of bone marrow involvement in patients with multiple myeloma (MM), in comparison with standard whole-body MRI protocol. Patients with biopsy-proven MM, who underwent a WBMRI with full-body coverage (from vertex to feet) were retrospectively enrolled. WBMRI images were independently evaluated by two expert radiologists, in terms of infiltration patterns (normal, focal, diffuse, and combined), according to location (the whole skeleton was divided into six anatomic districts: skull, spine, sternum and ribs, upper limbs, pelvis and proximal two-thirds of the femur, remaining parts of lower limbs) and lytic lesions number (<5, 5-20, and >20). The majority of patients showed focal and combined infiltration patterns with bone lesions predominantly distributed in the spine and pelvis. As skull and lower limbs are less frequently involved by focal bone lesions, excluding them from the standard MRI protocol allows to obtain a shorter protocol, maintaining a good diagnostic value.

Keywords: diffusion-weighted imaging; hematologic neoplasms; infiltration pattern; magnetic resonance imaging; multiple myeloma.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
(A) T2-weighted short-tau inversion recovery (STIR) and (B) T1-weighted turbo spin-echo sequences acquired on the coronal plane from the skull vertex to feet.
Figure 2
Figure 2
(A) T1-weighted turbo spin-echo and (B) T2-weighted short-tau inversion recovery (STIR) sequences of the spine acquired on the sagittal plane, showing multiple focal bone lesions hypointense on T1 sequences and hyperintense on T2 sequences, in a patient with focal infiltration pattern of multiple myeloma.
Figure 3
Figure 3
Focal infiltration pattern of multiple myeloma characterized by bone lesions of the spine (A,B) and the rib (C,D). Focal bone lesions of the spine are visible as a focal area of hypointensity on T1-weighted turbo spin-echo sequence (A) and of hyperintensity on T2-weighted short-tau inversion recovery (STIR) sequence (B) in L2, L3, and S1. Focal bone lesion of the rib is visible as focal area (arrow) of hypointensity on T1-weighted turbo spin-echo sequence (C) and of hyperintensity (arrow) on T2-weighted short-tau inversion recovery (STIR) sequence (D) in the costal angle of the ninth right rib.
Figure 4
Figure 4
ROC curves of standard protocol (SP) and three different short protocols (shP1, shP2, shP3).
See this image and copyright information in PMC

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